<form class="layui-form layui-box" style='padding:25px 30px 20px 0' action="{:url()}" data-auto="true" method="post">

    <div class="layui-form-item">
        <label class="layui-form-label">报告地址</label>
        <div class="layui-input-block">
            <input type="text" name="name" value='{$vo.name|default=""}' required="required" title="请输入报告地址" placeholder="请输入报告地址" class="layui-input">
        </div>
    </div>

    <div class="layui-form-item">
        <label class="layui-form-label">手机号码</label>
        <div class="layui-input-block rw30">
            <input type="text" name="mobile" value='{$vo.mobile|default=""}' required="required" title="请输入手机号码" placeholder="请输入手机号码" class="layui-input">
        </div>
    </div>

    <div class="layui-form-item">
        <label class="layui-form-label">订单号</label>
        <div class="layui-input-block rw30">
            <input type="text" name="order_sn" value='{$vo.order_sn|default=""}' required="required" title="请输入订单号" placeholder="请输入订单号" class="layui-input">
        </div>
    </div>

    <div class="hr-line-dashed"></div>

    <div class="layui-form-item text-center">
        {if isset($vo['id'])}<input type='hidden' value='{$vo.id}' name='id'/>{/if}
        <button class="layui-btn" type='submit'>保存数据</button>
        <button class="layui-btn layui-btn-danger" type='button' data-confirm="确定要取消编辑吗？" data-close>取消编辑</button>
    </div>

</form>
